I just read his book Functional Approach to Hypothyroidism and he seems to integrate well the mainstream perspective with alternative views like STTM including why many do not do well long-term on NDT or high amounts of T3 either.
The crux of his argument is that pure T4 therapy is optimal only for a minority, but going too high with T3 supplementation in relation to T4 is also bad long term and will cause people to crash as it pushes TSH too low and depletes T4. He thinks the ratio in NDT is way too high for most and for most the optimal ratio to supplement will be closer to 67 : 1 than 5 : 1 T4/T3.
This also means that ideal amounts of T3 will be far lower than what is found in most pills, this is the reason many studies find no benefit of added T3 since the dose is at least 10-fold higher than the ideal. He thinks most people should not get more than 0.5 - 1.5 mcg T3 per day, preferably in time-release capsules, combined with 25-50 mcg of T4.
Also that the main reason why people feel bad with too much T4 is that it suppresses TSH too much which reduces tissue T4->T3 conversion, its not related to rT3.
Also thinks its better to take T4 at dinnertime to improve sleep and reduce tendency to weight gain.
Thoughts on his book? Has anyone tried his approach to treat hypo? He's also big on time-release T3 capsules but these seem not to be that readily available.
The crux of his argument is that pure T4 therapy is optimal only for a minority, but going too high with T3 supplementation in relation to T4 is also bad long term and will cause people to crash as it pushes TSH too low and depletes T4. He thinks the ratio in NDT is way too high for most and for most the optimal ratio to supplement will be closer to 67 : 1 than 5 : 1 T4/T3.
This also means that ideal amounts of T3 will be far lower than what is found in most pills, this is the reason many studies find no benefit of added T3 since the dose is at least 10-fold higher than the ideal. He thinks most people should not get more than 0.5 - 1.5 mcg T3 per day, preferably in time-release capsules, combined with 25-50 mcg of T4.
Also that the main reason why people feel bad with too much T4 is that it suppresses TSH too much which reduces tissue T4->T3 conversion, its not related to rT3.
Also thinks its better to take T4 at dinnertime to improve sleep and reduce tendency to weight gain.
Thoughts on his book? Has anyone tried his approach to treat hypo? He's also big on time-release T3 capsules but these seem not to be that readily available.
Last edited: